Development and Testing of a Five-Item Version of the Geriatric Depression Scale

OBJECTIVE: To develop and test the effectiveness of a 5‐item version of the Geriatric Depression Scale (GDS) in screening for depression in a frail community‐dwelling older population. DESIGN: A cross‐sectional study. SETTING: A geriatric outpatient clinic at the Sepulveda VA Medical Center, Sepulve...

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Published in:	Journal of the American Geriatrics Society (JAGS) Vol. 47; no. 7; pp. 873 - 878
Main Authors:	Hoyl, M. Trinidad, Alessi, Cathy A., Harker, Judith O., Josephson, Karen R., Pietruszka, Fern M., Koelfgen, Maryanne, Mervis, J. Randy, Fitten, L. Jaime, Rubenstein, Laurence Z.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-07-1999 Blackwell Wiley Subscription Services, Inc
Subjects:	Activities of Daily Living Aged Aged, 80 and over Biological and medical sciences Cross-Sectional Studies depression Depressive Disorder - classification Depressive Disorder - diagnosis Female Frail Elderly GDS Geriatric Assessment Geriatrics Health Status Humans Interview, Psychological - methods Likelihood Functions Male Mass Screening - methods Medical sciences Medical screening Mental depression Mental Health Older people Prevalence Psychiatric Status Rating Scales - standards Psychology. Psychoanalysis. Psychiatry Psychometrics. Diagnostic aid systems Psychopathology. Psychiatry Reproducibility of Results Sensitivity and Specificity Severity of Illness Index Techniques and methods Human Mood disorder Abbreviated form Geriatric Depression Scale Yesavage Evaluation scale Receiver operating characteristic curves Depression Psychometrics Test reliability Elderly
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Summary:	OBJECTIVE: To develop and test the effectiveness of a 5‐item version of the Geriatric Depression Scale (GDS) in screening for depression in a frail community‐dwelling older population. DESIGN: A cross‐sectional study. SETTING: A geriatric outpatient clinic at the Sepulveda VA Medical Center, Sepulveda, California. PARTICIPANTS: A total of 74 frail outpatients (98.6% male, mean age 74.6) enrolled in an ongoing trial. MEASUREMENTS: Subjects had a comprehensive geriatric assessment that included a structured clinical evaluation for depression with geropsychiatric consultation. A 5‐item version of the GDS was created from the 15‐item GDS by selecting the items with the highest Pearson x1 correlation with clinical diagnosis of depression. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for the 15‐item GDS and the new 5‐item scale. RESULTS: Subjects had a mean GDS score of 6.2 (range 0–15). Clinical evaluation found that 46% of subjects were depressed. The depressed and not depressed groups were similar with regard to demographics, mental status, educational level, and number of chronic medical conditions. Using clinical evaluation as the gold standard for depression, the 5‐item GDS (compared with the 15‐item GDS results shown in parentheses) had a sensitivity of. 97 (.94), specificity of. 85 (.83), positive predictive value of. 85 (.82), negative predictive value of. 97 (.94), and accuracy of. 90 (.88) for predicting depression. Significant agreement was found between depression diagnosis and the 5‐item GDS (kappa = 0.81). Multiple other short forms were tested, and are discussed. The mean administration times for the 5‐ and 15‐item GDS were. 9 and 2.7 minutes, respectively. CONCLUSIONS: The 5‐item GDS was as effective as the 15‐item GDS for depression screening in this population, with a marked reduction in administration time. If validated elsewhere, it may prove to be a preferred screening test for depression.
Bibliography:	istex:D8765C27F9FC3BA3070FCA98EF4868950D6DC5FA ArticleID:JGS3848 ark:/67375/WNG-QFN9ML9Z-0 This article was presented, in part, at the 1998 Annual Meeting of the American Geriatrics Society and American Federation for Aging Research, Seattle, Washington, May 6–10, 1998. This study was supported by the Veterans Administration HSR & D Service, Grant No. 95–050.
ISSN:	0002-8614 1532-5415
DOI:	10.1111/j.1532-5415.1999.tb03848.x